AIM:
To train hip abduction (in supine) in preparation for mid to end stance phase of walking
Rationale:
An important component of the stance phase of walking is lateral horizontal pelvic shift. Patients must be able to contract the hip abductors, especially when the hip is in extension, to control this component. Task-related training is set up so the patient can practice with support from a plinth and/or manual guidance from the therapist if necessary.
Equipment:
- Adjustable height plinth
- Block (if necessary)
Key Points:
- Patient is in supine with the trunk positioned diagonally across the bed and the affected leg placed over the bedside. The affected leg is positioned so that the hip is in neutral or slightly flexed and is not abducted, the knee is flexed and the ankle is plantargrade
- Patient pushes down through the affected foot and lifts the bottom up off the bed and shifts it sideways
- Therapist provides manual guidance at the knee if necessary
- Therapist may provide a cue for range of movement using the hand
Common Errors:
- Patient extends shoulders into the plinth to lift bottom
Progression and Variety:
- Decrease/remove manual guidance
- Increase amplitude of movement
- Increase speed of movement